Imaging anal fistula

Bartram, Clive I.; Buchanan, Gordon

doi:10.1016/s0033-8389(02)00122-7

Cited by 68 publications

(47 citation statements)

References 48 publications

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“…Some methods have been used to this end: fistulography, magnetic resonance imaging, CT, and endoanal ultrasound scanning (7)(8)(9)(10)(11)(12). Ultrasound scanning with hydrogen peroxide enhancement is a scarcely invasive, easy to perform and low cost test when compared to other methods.…”

Section: Discussionmentioning

confidence: 99%

Is routine endoanal ultrasound useful in anal fistulas?

Migueláñez¹,

Garcı́a-Olmo²,

Martínez-Puente³

et al. 2005

Rev. esp. enferm. dig.

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Objective: to evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening), and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique.Patients: endoanal ultrasound was performed in 103 patients with anal or perianal suppuration. Twenty patients were excluded: 9 had the external opening closed, and 11 had cryptoglandular abscesses. All ultrasound scans were performed by the same explorer using a B&K Diagnostic Ultrasound System with a 7 MHz endoprobe. The examination was based on the identification of the three anal planes, then hydrogen peroxide was infused and the procedure was repeated.Results: out of 83 patients included, 11 had a perianal sinus and 72 an anal fistula. In all fistulas the main tract was found: 24 were inter-sphinteric (33.33%), 33 trans-sphincteric (45.83%), 3 supra-sphincteric (4.17%), and 12 extra-sphincteric (16.67%). An internal opening was identified in 69 (95.83%).Conclusions: endoanal ultrasound with hydrogen peroxide enhancement is an effective examination to visualize fistulous tracts and internal openings. We think it is highly useful for anal or perianal suppuration to identify abscesses, to recognize a perianal sinus, to check the sphincteric condition, and to plan subsequent surgery.

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Section: Discussionmentioning

confidence: 99%

Is routine endoanal ultrasound useful in anal fistulas?

Migueláñez¹,

Garcı́a-Olmo²,

Martínez-Puente³

et al. 2005

Rev. esp. enferm. dig.

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“…During the last decade, MRI has evolved into a current standard of practice for perianal fistulas [10][11][12][13]. Intestinal fistulas of more proximal origin, however, have only recently been studied by MRI [14][15][16][17][18], all secondary to Crohn's disease.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

et al. 2007

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The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1-and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions.

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“…Interestingly, this presentation is very similar to that previously reported by Parks and Thompson 2 in a series of 33 patients with an intersphincteric abscess in the absence of CD; 52% of these patients were diagnosed on the basis of a physical examination, whereas the others required exploration under anesthesia. AUS has been advocated as the imaging technique of choice for initially assessing patients with a suspected septic complication in situations of anal pain with no clinical findings, 16 and our data suggest that the diagnostic yield of this technique may be even greater in patients with CD and anal pain, in whom perianal inflammation is relatively more frequent.…”

Section: Discussionmentioning

confidence: 66%